Biomechanical effect of mandibular advancement device with different protrusion positions for treatment of obstructive sleep apnoea on tooth and facial bone: A finite element study

Abstract

Mandibular advancement at 70% of maximum protrusion induces risks of tooth root resorption and bone resorption. The mandibular second molars were subjected to the highest stresses. Stress on the teeth and facial bones was the lowest at 40% of maximum mandibular advancement.

An investigation into structural behaviors of skulls chewing food in different occlusal relationships using FEM

“…Finite element (FE) analysis has been widely used to simulate different behaviors in dentofacial orthopedics and dental biomechanics (Ammar, Ngan, Crout, Mucino, & Mukdadi, ; Borcic et al, ; Cattaneo, Dalstra, & Melsen, ; Chang, Shin, & Baek, ; Field et al, ; Geramy & Morgano, ; Hsu, Chen, Chen, Huang, & Chang, ; Kibi et al, ; Lee, Choi, Lee, Ahn, & Noh, ; Liang, Rong, Lin, & Xud, ; Liu, Chang, Wong, & Liu, ; Rudolph, Willes, & Sameshima, ; Singh, Mogra, Shetty, Shetty, & Philip, ; Soares et al, ; Toms & Eberhardt, ; Vukicevic, Zelic, Jovicic, Djuric, & Filipovic, ; Yu, Baik, Sung, Kim, & Cho, ; Zhang, Cui, Lu, & Wang, ), because of many problematic issues in clinical testing, such as subject discomfort and limit of accessible areas. In the study conducted by Lee et al (), FE analysis was performed to investigate the mechanical effect of different protrusion positions of a mandibular advancement device (MAD) on teeth and facial bones, since the MAD‐induced stress and strain have not been measured directly from living structures. Ammar et al () used the FE jawbone model to simulate canine retraction with mini‐screw anchorage and compared stresses on the mini‐screw and fracture failure of tangential orthodontic forces.…”

Force Distribution of a Novel Core-Reinforced Multilayered Mandibular Advancement Device

“…In addition, the mandible moves antero-posteriorly when a MAD is applied, so the restorative force is directly transmitted to the anterior teeth. However, recent FEM studies [ 23 , 34 ] showed that load concentration induced by MADs was greater on the posterior teeth than on the anteriors; therefore, it is necessary to evaluate force distribution on the overall dentition as well as on the anterior teeth.…”

“…Our results also highlighted that attention should be paid to the transverse dimension of the posterior teeth during the long-term use of MADs, as well as the anteroposterior movements of the incisors. Previously, Lee et al [ 23 ] showed the highest force value in the mandibular second molar; therefore, it is likely to be inclined lingually. In contrast, in our study, the mandibular second molar indicated had the lowest force value.…”

“…The posterior restorative force produced from the relaxation of the mandibular muscles was represented by the restoring force of the spring. The posterior restorative force on the mandible is primarily caused by stretching of the two masticatory muscles, the deep masseter and posterior temporal muscle [ 23 ]. The spring tension stiffness values of these two muscles were 16.35 N/mm and 13 N/mm, respectively [ 24 ], and the force values generated by the MADs were approximately 100 gF for each millimeter of advancement [ 25 ].…”

“…An analysis of the force system applied to the dentition should precede the anticipation of the direction and extent of tooth movement after the use of MADs. Recently, Lee et al [ 23 ] analyzed the biomechanical effect of different protrusion positions of a MAD on the teeth and facial bones using finite element analysis (FEM). According to their results, both the incisors and mandibular molars, especially the buccal surface of second molars, were subjected to high stress, which caused lingual inclination of the molars.…”